Women's Access to Health Care Linked to Better Living - 2003-08-20

Whether women have access to health care has social repercussions in rich and poor nations alike. In the first of two reports, Correspondent Laurie Kassman looks at the barriers to providing access in developing nations of the world and why it matters.

There is a growing recognition around the world that women's health care is a key building block for society.

"Countries that have invested in women, typically you can see the health indicators are better over all," explains Lori Ashford, senior policy analyst at the Population Reference Bureau in Washington. "If you invest in women's health, infant deaths will also drop, because healthier women have healthier babies, and more educated women have healthier babies."

She cites Iran as an example where women's access to health care has improved in a mostly rural society by bringing health care to the women where they live.

"They established rural health care networks revolving around health houses that provide basic preventative care, like family planning, vaccination," she says. "And, women health care workers visit people's homes to educate them about health care, to inquire about needs and make sure kids are vaccinated."

Ms. Ashford says the rate of maternal deaths over the past two decades has dropped by two-thirds. The number of infant deaths in Iran has been cut in half.

In contrast, Zambian health officials say the rising number of maternal deaths there can be blamed in part on poor access for women to proper health care.

In many of the poorest regions of the world, health services are overburdened and understaffed. Providing women access to health services often is a major challenge.

The barriers are often physical, financial and psychological. The list is long: no transportation or child care, few or no medical supplies or trained staff to keep a clinic open, no money to pay for medicines, or a patient's inability to read and write to follow instructions or fill out forms. In traditional societies, women often are restricted to their homes and cannot venture out without a male escort.

Kathleen Kurz directs the Reproductive Health and Nutrition Program for the International Center for Research on Women. She says breaking down the barriers often relies on innovation and cooperation at the grassroots level and the commitment of political, social and religious leaders. But she says setting up a clinic is only half the challenge.

"Can a woman walk into that clinic anyway? When you trace it backwards, does she acknowledge her own health problem? Does she mention it to someone else in the family, so they can start thinking about what to do to address this?" she asks. "Does she have the support from a husband and also the in-laws and elders in the household; because women in many parts of the world move to their husband's home when they get married."

And then, can the money be mobilized for her transport and health care and any services or medicines they have to buy? So, there are many questions and many steps behind a woman actually walking through the clinic door to get health services," she adds.

War and civil strife in many parts of Africa and Asia also have victimized women, and forced them to flee their homes and traditional care networks. So has the spread of AIDS.

Ms. Kurz points to Latin America as a bright spot on the horizon. She attributes much of the improvement there to the growing recognition and treatment of women as equal partners in society.

"The other [reason] is, the governments have been stronger, so less is lost to ethnic problems or corruption. So, I think stronger government and this notion that women are equal has been increasing," she says.

Analysts like Lori Ashford of the Population Reference Bureau say financing women's health care remains a major challenge for developing countries with dwindling resources and rapidly growing populations

"Even if they were to maintain their current level of health care, they would fall behind, because they have growing numbers of people in the population and more women of reproductive age that need to be served," she explains.

Even so, healthcare advocates say that more nations are recognizing healthcare as a national priority, and finding ways to implement cost-effective grassroots programs that can make a difference.